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精神障碍与他汀类药物使用:倾向评分匹配分析。

Psychologic disorders and statin use: a propensity score-matched analysis.

机构信息

Brooke Army Medical Center, San Antonio, Texas, USA.

出版信息

Pharmacotherapy. 2013 Jun;33(6):615-26. doi: 10.1002/phar.1272. Epub 2013 Apr 26.

Abstract

STUDY OBJECTIVE

To evaluate the association between statin therapy and the risk of psychologic disorders including schizophrenia, psychosis, major depression, and bipolar disorder in a military population.

DESIGN

Retrospective, observational, population-based, propensity score-matched, cohort study.

SETTING

Database of a patient population enrolled in the San Antonio Military Multi-Market Area as Tricare Prime or Plus.

PATIENTS

Medical records were reviewed from 46,249 patients aged 30-85 years who were continuously enrolled in the San Antonio Military Multi-Market Area as Tricare Prime or Plus from October 1, 2003-March 1, 2010. Data were obtained from the Military Health System Management Analysis and Reporting Tool (M2). Based on drug fills during fiscal year 2005, patients were stratified as statin users (13,626 patients received at least 90-days supply of statin) or nonusers (32,623 patients never received a statin during the study period). A propensity score-matched cohort of 6972 statin users and 6972 nonusers from this population was created.

MEASUREMENTS AND MAIN RESULTS

The occurrence of psychologic disorders between October 1, 2005, and March 1, 2010, was determined using prespecified groups of ICD-9-CM, Psych1: schizophrenia, schizoaffective disorders, and other psychosis; Psych2: major depression and bipolar disorder; Psych3: all psychologic disorders as identified by the Agency for Health Research and Quality-Clinical Classifications (except for categories of childhood or developmental psychiatric disorders). Between matched pairs of statin users and nonusers, the odds ratios and 95% confidence intervals were as follows: Psych1 (0.9, 0.75-1.05), Psych2 (1.02, 0.94-1.11), and Psych3 (1.02, 0.96-1.1), respectively.

CONCLUSION

The risk of developing psychologic disorders was similar in this cohort of propensity score-matched statin users and nonusers.

摘要

研究目的

评估他汀类药物治疗与精神障碍风险之间的关联,包括军队人群中的精神分裂症、精神病、重度抑郁症和双相情感障碍。

研究设计

回顾性、观察性、基于人群的倾向评分匹配队列研究。

研究地点

数据库来源于在圣安东尼奥军事多市场地区参加 Tricare Prime 或 Plus 的患者人群。

研究对象

对 2003 年 10 月 1 日至 2010 年 3 月 1 日期间,连续参加圣安东尼奥军事多市场地区 Tricare Prime 或 Plus 的 46249 名年龄在 30-85 岁的患者的医疗记录进行了回顾。数据来源于军事卫生系统管理分析和报告工具(M2)。根据 2005 财年的药物使用情况,患者被分为他汀类药物使用者(13626 名患者接受了至少 90 天的他汀类药物治疗)或非使用者(32623 名患者在研究期间从未接受过他汀类药物治疗)。从该人群中创建了一个由 6972 名他汀类药物使用者和 6972 名非使用者组成的倾向评分匹配队列。

测量和主要结果

使用 ICD-9-CM、Psych1:精神分裂症、分裂情感障碍和其他精神病;Psych2:重度抑郁症和双相情感障碍;Psych3:所有精神病,由美国卫生研究与质量临床分类(不包括儿童或发育性精神疾病类别)确定的特定组,确定 2005 年 10 月 1 日至 2010 年 3 月 1 日期间精神障碍的发生情况。在他汀类药物使用者和非使用者的匹配对中,优势比及其 95%置信区间分别为:Psych1(0.9,0.75-1.05)、Psych2(1.02,0.94-1.11)和 Psych3(1.02,0.96-1.1)。

结论

在这个倾向评分匹配的他汀类药物使用者和非使用者队列中,发生精神障碍的风险相似。

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